abeautifulday

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Dec 30, 2011
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Hi Guy,

Can you help me or give some tips to answer to some ethical issue question related to pharmacy?
1. If there was a drug you know that was toxic to a patient, how would handle the situation? What if the doctor strongly disagreed with you, then what would you do as a pharmacist?
My answer I would tell the patient that the drug is toxic and ask him/her to wait for me to call the doctor. I would go over the drug and talk with the doctor about drug and ask to go over the drug to make sure the doctor doesn:t prescribe a toxic drug.
2. What are your thoughts about assisted-suicide and how would you respond to a customer/ patient whose questions about a medication caused you to suspect that they were intending to use them in this way?
I would go over the patient:s profile to make sure if the patient would use the medication for medical or assisted-suicide purpose. Then, I would call his/her doctor and also refer to him/her to some department in the hospital that can help them to make the decision.
3. In your experience with pharmacist, what would you say is the biggest challenge that pharmacists face?
I wonder if I can talk about the oversupply of pharmacists and too many pharmacy school open? I:ve been searching for this question, but I don:t find a solid one.

Any opinion or thought about these questions and my answer are welcome
 

bananaface

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I like that you tried answering the questions yourself instead of just asking for answers. :)

1) I agree that if I felt that something was likely to be toxic, I would not dispense, even if the prescriber were insistent. Some issues that can come up are that you want to tell the patient in a way that will not undermine their relationship with the prescriber. And, you want to be tactful with the physician, since you presumably will have to work with them in the future. Ideally you want to convince the physician to do something else, so you may need to present alternatives. This question could also come up in a handful of states where physician assisted suicide is legal and would be a chance for you to discuss your views on that topic. Chances are if you were in a state where it were legal they'd just ask you up front about it, though.

2) In my state if an Rx is for assisted suicide it must say so on the Rx face, be for a terminally ill patient, and the pharmacist has to make sure it complies with our state law for dispensing of such meds, if they are willing to participate. I am not opposed to assisted suicide personally, having watched both of my parents pass away in a great deal of pain and discomfort. If someone wants to skip the final phases of a terminal illness, I say more power to them. But, I also have to uphold my professional responsibility and refer anyone I think is suicidal to an appropriate care provider (or call 911 if appropriate) and dispense only legally prescribed medications for legitimate medical purposes. If a patient expressed interest in assisted suicide, then I would tell them that it is legal in our state and that they should speak to their physician about their options. I feel that I would need to be supportive of the patient but not steer them one way or the other. It is really their life and their decision, not mine.

3) You can talk about whatever you want to with this one. But if you say oversupply, you may get asked why you are choosing pharmacy in spite of the overage. Personally, I detest the working conditions that have sprung up as a result of the overage drying up. I liked having enough support staff to care for my patients to the best of my ability. Now it seems like everyone in retail is trimming hours to the detriment of patient care. $4 generics is another one you could throw in there - undercutting the value of pharmaceutical care so that the public perceives that meds should be cheap and care should be free. Lots of possible topics. Just pick a soap box you feel comfortable on.
 
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DrDrugs2012

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Ethical questions in interviews have two basic commonalities:
1) There are a number of wrong answers but no "right" answer. The interviewers are not looking for a specific response but they are looking for your ability to rationalize a complicated situation by putting your critical thinking skills to work.
2) You rarely have enough information to answer the question. Dilemmas are conundrums only because you dont have a good sense of the complete picture. As a result, most people make colossal assumptions about the scenario. Let me point out some assumptions you are making in your first answer. A) you assume that something which is toxic is inherently bad or even overall bad, B) assumed that the physician is wrong. Now let me rephrase the question: you receive a prescription for a cocktail contaibing cisplatin, methotrexate, doxorubicin, and vinblastine - four of the most dangerous chemotherapeutic drugs out there. Would you still be challenging the physician? I wouldnt. Aside from the fact that pretty much by definition that all chemotherapeutic drugs are "toxic", the physician would obviously be an oncologist, and with that regimen it would obviously be a salvage therapy for someone who failed one or more previous rounds of chemotherapy. My concern would be the absence of a prescription for more drugs which help manage the adverse events associated with the chemo cocktail.

The best response usually starts with "I dont have enough information to properly evaluate the question, so here are a couple of assumptions I am making (insert assumption and then proceed). Your answer is fine as long as you preceded it with the assumption you are making is that the interviewer wants to pose a scenario in which the pharmacist believes the drug is more dangerous than good and that the physician is incorrect.​
 
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abeautifulday

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I thank a lot two of us helping me. This info will help me a lot and make me. I don:t know a lot about the pharmacy law and somewhat not sure about my answer
 

bananaface

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Every once in a while there may be a school that asks a moral question and wants you to answer a certain way in order to assure that you fit with their institutional ideals. One school I interviewed at long ago would ask everyone how they handled a group member not carrying their weight. You were supposed to try to figure out why the other student was not carrying their weight and try to help them resolve the issue. One would hope that a reasonable answer would be given good marks. But there are still some places that lock themselves into what they are looking for. You just have to hope you give a good answer and realize that if the "right" answer is not easily found, probably no one else is giving it either. Don't sweat it and just answer to your own satisfaction.

Keep in mind that schools won't expect any sort of clinical knowledge from a pre-pharm. So, not answering like a pharmacist is kind of expected. At this point your intrapersonal skills, behaviors, ability to communicate clearly, and motivations are the biggest indicators of your potential.
 

bananaface

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Your answer to #2 did not include your opinion about assisted suicide, so you should also give your thoughts on that to make a complete answer. A good interviewer would get a complete answer by asking a follow up question. Many interviewees would not know the law either, so knowing it is probably just bonus. What I liked about your answer is that you seemed to be trying to act in the best interest of the patient. And, you involved the patient's physician.